Society for Vascular Surgery: Original ArticlesThrombectomy with temporary arteriovenous fistula: The treatment of choice in acute iliofemoral venous thrombosis*,**
Section snippets
Material and methods
From July 1, 1979, to June 30, 1982, 63 patients admitted to Helsingborg County Hospital and to the University of Lund, Sweden, with acute iliofemoral venous thrombosis met the following criteria for inclusion into the present study:
- 1.
Deep venous thrombosis with proximal extension above inguinal ligament but below caval bifurcation
- 2.
Swelling of entire leg for less than 7 days
- 3.
Present pedal pulses
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Neither anticoagulation nor surgery contraindicated
- 5.
No history or sign of congestive heart failure
- 6.
No
Results
Both conservatively and surgically treated patients experienced a rapid decrease in leg swelling. The difference in calf circumference when comparing the two legs decreased during the first week from 4.3 ± 2.0 cm (mean ± SD) to 2.6 ± 1.8 cm in the conservative group and from 3.8 ± 2.2 to 2.0 ± 1.8 cm in the surgical group. The hospital stay ranged from 5 to 23 days (median 9 days) in the conservative group and 7 to 35 days (median 11 days) in the surgical group.
Early complications were
Discussion
Acute deep venous thrombosis is treated conservatively in most institutions. Previous reports of anticoagulation treatment in acute iliofemoral thrombosis have demonstrated that initial lysis is rare.2, 10, 17, 28 The incidence of recanalization of the iliofemoral segment, development of sufficient collateral flow, and preservation of femoropopliteal valvular competence after conservatively treated iliofemoral thrombosis is not well known because of a low incidence of follow-up phlebography in
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Cited by (0)
- *
Supported by The Thorsten and Elsa Segerfalk Foundation for Medical Research and Education and by The Salus' Fifty-Year Foundation for Medical Research.
- **
Reprint requests: Gunnar Plate, M.D., Dept. of Surgery, Helsingborg County Hospital, S-25187 Helsingborg, Sweden.